The Value Of NIHSS, APACHE Ⅱ,MEWS And GCS Scales Predict The Long-term Prognosis Of Patients With Acute Cerebral Stroke

Objective:To evaluate the predictive value of acute physiology and chronic health evaluation II(APACHE II), national institutes of health stroke scale(NIHSS), Glasgow coma scales(GCS), Modified early warning score(MEWS) in one year outcomes for patients with acute cerebral stroke. Methods:From March 2014 to September 2014 the first affiliated hospital of xinjiang medical university, 279 cases of patients with acute cerebral stroke, 15 cases were lost to follow-up, during the final in 264 cases, among which 168 were male, female 96 cases, with an average age of 64.39 years, Hospital within 2 h for APACHEII, NIHSS, GCS, MEWS, record the patient’s general information and follow-up its prognosis, according to the prognosis of patients after follow-up its 30 d, 90 d, 180 d, 1 y survival situation, all cases according to the survival situation can be divided into survival group(186 cases) and death group(78 cases). The general data of 2 patients were statistically analyzed, statistics by SPSS 17.0 software, count data using t test or rank and inspection, measurement data using X2 test, the subjects working curve calculation, NIHSS, GCS, APACHE II MEWS the specific degree of prognosis in patients with cerebral apoplexy and sensitivity, comparing Z test area under the ROC curve. Result:A total of 264 patients were included in the study(not including 15 patients with lost to follow-up), 30 d’s mortality was 22.73%, 90 d’s mortality was 26.14%, 180 d’s mortality was 28.41% and the mortality rate of a year was 30.68%, the area under the ROC curve APACHE II score was 0.788 ± 0.035, NIHSS score was 0.802 ± 0.033, MEWS score was 0.719 ± 0.035, GCS score was 0.218 ±0.034, each score the best cutoff to predict the prognosis of patients with acute cerebral stroke is as follows: GCS to 7 points, NIHSS for 13 points, APACHE II for 15 points, MEWS for 3 points. Conclusion:APACHE II, MEWS, GCS and NIHSS has good prediction of the effects of long-term prognosis in patients with acute cerebral stroke, NIHSS of area under the ROC curve, the largest MEWS of minimum area under the ROC curve, but no statistical difference between different grades(Z are less than 1.96), but from the time needed for evaluation, GCS and MEWS score required time is short, less evaluation project, more suitable for first-aid system evaluation.